Altruistic kidney donation: Would you give a kidney to a stranger?

039.JPG Marion Pattinson on the left, Clare Bolitho holding the chocolate cake Marion’s daughter made for Clare and Nigel, Marion’s partner is on the right.

Lots of us donate blood. And while we don’t know who is lucky enough to receive our personal batch, we do know it could save a life. But would you donate a kidney to a stranger?

Last year, around 3,000 kidney transplants were performed in Britain. Most were taken from donors who had died but more than 1,000 of were from living donors, typically relatives of the recipients. Only 76 were from complete strangers.

‘Everyone is someone’s mother, brother, friend,’ says Clare Bolitho, a vet from Shropshire who donated her kidney in March 2011. ‘Just because it’s not your family member doesn’t mean they deserve it any less.’

Altruistic donation is when a healthy person gives their kidney to a stranger. It only became legal in Britain in 2006 and it remains illegal to do it for money. Before 2006, all living donations were from friends or relatives. However, after scandals such as organs being retained without permission at Alder Hey Children’s Hospital in Liverpool between 1988 and 1995, The Human Tissue Act put together a framework for altruistic donations.

Last month, Give A Kidney, the only charity in this field, celebrated the 250th altruistic donation. And for Bolitho March marks the third anniversary of her operation.

After suffering anorexia and alcoholism as a young woman, Bolitho, 62, wanted to give something back. ‘I wanted to mark being alcohol-free for 21 years,’ she says. ‘So I thought what better way to celebrate getting my life back than by helping someone else get their life back?’

Possible donors go through months of physical and psychological tests; Bolitho’s process took more than a year. Typically, a kidney is removed via keyhole surgery in the abdomen under general anaesthetic and then transported to the recipient’s surgeon for transplantation.

Although we are born with two kidneys, it is safe to live with one and donation does not increase the risk of kidney failure later in life (see box, right). Risks are usually associated with the surgery itself and can include infection, bleeding and blood clots.

‘Of the 6,000 people in need of a kidney in Britain, 300 can expect to die this year,’ says Dr Chris Burns-Cox, co-founder of Give A Kidney. ‘That’s almost one person a day. Humans only need one kidney to live a perfectly normal life and donors can be aged between 20 and 80, so there are millions of people walking around with the potential to save a life in this way.’

Burns-Cox, 76, co-founded the charity in 2011 after donating his own kidney to a stranger.

While most altruistic donors never meet their recipient, Bolitho’s was an unusual case as she and her match waived their right to anonymity.

You only need one kidney to live – and if you donate one, the other soon adapts (Picture: Getty)

Marion Pattinson, 48, from Lincolnshire, has suffered from Type 1 diabetes since she was ten. She now needs four insulin injections a day. Over time, excessive glucose damaged the tiny blood vessels in her kidneys and she was told she would need a transplant. ‘My husband also has diabetes and my daughter has heart problems,’ explains Pattinson. ‘And my parents have health concerns so I thought I would just have to put up with my kidney function going downhill. When I was told a stranger was a match, it was like winning the lottery.’

Although Pattinson now also needs a pancreas transplant, she says the kidney has changed her life. ‘I have much more energy and I feel so much better,’ she says.

Pattinson and Bolitho meet on every anniversary of the transplant – Bolitho even sends her old kidney a card. ‘Marion has got so much more out of life and doesn’t spend hours on dialysis,’ says Bolitho. ‘It’s been quite an adventure and my experience has been extremely positive. I don’t know if I’ve saved Marion’s life but I’ve certainly helped her. I don’t know why more people don’t choose altruistic donation for that reason.’

The kidneys are the body’s filtering system. They take waste products from the blood and excrete them in urine. Although most people are born with two, it is safe to live with one.

‘As with all operations, there are some risks but these are usually involved in the process of removal and not at being left with one kidney,’ says Paul van den Bosch, a GP in Surrey with a particular interest in kidney disease, who has himself donated a kidney. ‘The remaining kidney will naturally increase in size and levels of waste products in the blood quickly return to normal.’

According to the NHS, there is an 85 to 90 per cent chance transplants from deceased donors will work well after a year. For living donors, it’s slightly higher: 90 to 95 per cent.
‘This is because living kidneys are in a better condition and because the operation can be planned,’ says van den Bosch.

While there is a one in 3,000 chance of death for the donor, van den Bosch says to bear in mind that the risk of an average man in his mid-fifties dying in the next year is about one in 500. ‘In the year of the operation, he would be far more likely to die from an unrelated cause than from the operation,’ says van den Bosch.

There is a slight risk of increased blood pressure or excess protein in the kidney but van den Bosch says studies show no long-term effects. Kidney transplants also save the NHS money, as dialysis costs around £20,000 a year per patient.

Lucy Allan, 18, unemployed from Middlesex
‘I have vaguely heard of altruistic donation and I’d give my kidney to a stranger. I only need one, so if someone needed one why wouldn’t I? I already give blood.’

Ashley Powys, 20, PA from Wales
‘I can’t give blood as I’m gay, but if I could I would. I would consider giving a kidney but I would like to know about the recipient first. It sounds awful but I’d want them to be deserving.’

Sylvia Wirmer, 32, mother of three from Brazil
‘I would prefer not to donate in case one of my children needed a kidney. If I didn’t have people dependent on me then I would definitely consider it.’

Chaba Molefi, 18, student from London
‘I would consider it. The best giving is when you don’t know who you’re helping. If one day I had children who needed a kidney, the world has a way of coming round again.’

Zee Nobles, 72, retired nurse from the US
‘My friend gave a kidney to her diabetic husband but he died a week later. I worked on a heart transplant ward. You can’t predict who’ll do well. I wouldn’t donate to a stranger.’

Sergey Besim, 28, manager from Ukraine‘I would give my kidneys when I was dead but I’m not sure whether I would give an organ if I was alive. Maybe a relative would need it. If I was older and had no children then it’s a possibility later in life to donate then.’

Mary Huang, 48, IT consultant from Canada
‘In Canada we have the organ donation register, but I’m not on it. I do donate blood. I would probably donate a kidney to a friend of family member, but a stranger? I would have to think about. When it’s someone you know it’s an easy decision but if you don’t know them I would be worried about kidney failure and problems afterwards.’

Will Horder, 27, chartered surveyer from London
‘I don’t give blood, but it’s on my list. But giving a kidney doesn’t sound ideal. I would like to know where it goes. I would consider it, but it’s difficult. I don’t really know much about it and how it affects you afterwards and the risks.’